The National Health Service (NHS) is a uruque organisation which expenences continual change, making the management of the supply chain a particularly challenging area. Key relationships at the two ends of the supply pipelines between NHS buyers and their suppliers and between local NHS supplies managers and their customer base are therefore crucially important. Following the 1990 reforms and the introduction of the NHS internal market, an environment has been created in which managers are generally much more cost conscious and customer orientated. The net effect of these changes has been to raise the profile of the buyer-supplier and Supplies Manager-customer relationships. A review of the current literature has highlighted aspects of relationships that can be applied to those within the NHS supply chain as well as identifying some conceptual gaps. Initial exploratory surveys of supplies managers, NHS buyers, suppliers and end customers were undertaken with the emerging themes being further investigated through semi-structured interviews. Two relationship review tools were constructed and an action research approach adopted to evaluate the tools which involved Scottish NHS buyers with their suppliers and Scottish Supplies Managers with their end customers. The experience of the case studies suggest that the tools are a useful way of continually reviewing relationships which is necessary given the dynamic nature of the NHS. The research also suggests that purchasing relationships between NHS buyers and the suppliers currently exist along the whole of the relationship spectrum - from adversarial to partnership type - depending on the influence of particular factors. Both extremes have a place in the NHS buyer's "relationship portfolio", the challenge is to recognise when and how to adopt a particular type. The research suggests that the tool devised specifically for use by NHS Supplies Managers and their customers assists Supplies Managers in their task of identifying a means of ensuring flexible packages of care are offered to meet the increasing expectations of all customers.